Monday, December 23, 2013

As I have mentioned, I had a heck of a time deciding on which dental clinic to choose in Costa Rica. Once I had decided on CR, instead of Mexico, I became slightly obsessed with trying to find the perfect clinic for my treatment (remove the word "slightly" and the previous sentence becomes more accurate). The initial clinics that I learned of and researched are ones that I found out about on a forum where there is a thread dedicated to Costa Rica dentists. At the time of writing this, there are 4,937 posts on 247 pages in that thread and I read every single one. The information I found there became the foundation of my CR dental research. Soon I was researching 4 or 5 different clinics trying to decide which would be best. Then I would learn of another, then another and so on. Soon I had a list of over 20 potential clinics just in San Jose.

(click to enlarge map of clinics I considered)

Then I had this terrific idea. Why limit my search to San Jose? Why not look in smaller towns all around Costa Rica? Maybe I would find the perfect dentist tucked away in some tiny building in a sleepy beach town who would fix my entire mouth for a case of single malt scotch and a few Cuban cigars. In fact I did find a couple good prospects:

DR. Aborn just outside of Tamarindo. He is an American dentist who moved his practice to CR years ago. Highly experienced and highly respected by other doctors in CR. I talked to him via email a few times and I have nothing but great things to say about him. 1st class guy. (UPDATE: Dr. Aborn is now working with the fine people over at Dental Cosmetics in San Jose)

DR. Alberto Gonzalez in Quepos. Another outstanding doctor that I swapped emails with several times. If you want to stay on the coast during your dental procedure I would put this clinic on your list to contact.

So after spending another billion hours researching dentists outside of San Jose, I decided to go back and look at some of the first clinics that I learned of on the forum that I mentioned earlier. The clinics I'm about to list below are all clinics that I found to be highly recommended by American and Canadian patients that posted their experience on that forum or on their personal blog that I stumbled on. They are also clinics that I researched myself by looking at their credentials, education, experience, sending them my x-rays, asking for a estimate on a proposed treatment plan and speaking to them via email, phone call or both. I believe that the following doctors/clinics are highly capable of providing fantastic service at a price much lower than American and Canadian dentists. Some are specialists and others are general dentists. I would say that the 9 honorable mentions below all came in 2nd place in my attempt to find the best doctor for MY needed treatment. I would have been more than happy and confident to use any of them if, for some reason, I was unable to go to my final choice.

My doctors: Dr. Prada, Dr. Gonzalez & Dr. Carranza @ DDS Dental. How many times has someone, or even yourself, said, "trust your instinct"? I remember that when I first started researching dentists in Costa Rica, the DDS Dental website was one of the first I looked at. In fact it stayed open in a browser tab for days on my computer. It was everything I was looking for in a clinic. A Periodontist to do my implants and a Prosthodontist to do my teeth and to oversee it all. Excellent credentials, experience and reviews of all the doctors at DDS. But even though it was everything I was looking for, I still kept looking. Maybe I figured it was not wise to settle on one of the first clinics that I found. Or maybe I just didn't trust my instinct. I know this...if I would have listened to my gut feeling, trusted my instinct, I would have saved hundreds of hours of research. But truth be told I have really enjoyed all of this. From the first time I learned of the term "Dental Tourism" to the folder I have in my Dropbox account which contains notes upon notes of all my research. I think doing so much research into the midnight hour almost every evening will make the end result even more satisfying...either that or it will take about 5 years off my life.

Thursday, December 19, 2013

Sigh. So I had a few appointments set up with different dentists in Costa Rica. My plan was to go to these dentists for consultations, see what treatment plans they came up with and THEN choose which dentist/clinic to use. That way I could meet them first, see the proposed treatment plan and so on. I've heard of others doing this and it worked fine for them. But the more I thought about it the more I came to the conclusion that:

1) It's not really fair for the dentists

2) I want to have things set when I get there. Not worry about who the hell I'm going to choose.

3) The expense of multiple consultation fees

4) It's not really fair for the dentists

I hear what you all are saying out there..." Don't worry about the dentists, you have to do what is best for YOU! ". Yeah I hear you and I totally understand that side of the argument but it's just not me. I thought I could do it but I can't. About an hour ago I sent an email to those dentists, with the exception of one, telling them that I needed to cancel our appointment. Literally 10 minutes after sending that email I received a phone call from one of them. Yikes! But surprisingly he had not read the email yet, it was coincidence that he was calling at that time. You see many of the clinics, if not all, shut down for a week or two for the upcoming Christmas and New Year holidays and this particular doctor was just calling to confirm our appointment before he started his extra long holiday. I told him that I just sent an email to him 10 minutes prior and that unfortunately I had to cancel. How did he take it? Well on a scale from 1 to 10 (1 being calling me a #%@!* and a 10 being "No problem let me buy you dinner when you are here to show there are no hard feelings") I think it was about a 5. In one breath he said he understood while in the next breath he explained how this would mess up his schedule. Do I care? Of course I do...I feel like shit. Oh this might be a good time to tell you that this won't always be a G rated blog.

Anywho maybe I went about this all wrong but it's not everyday I go shopping for a dentist in a foreign country so try not to judge this rookie too harshly. This might sound strange but choosing a dentist in Costa Rica for my dental treatment is one of the hardest decisions I ever had to make. Think about it...who would you choose to rip the teeth out of your head, install titanium implants by drilling them into your jaw bone and then fasten new teeth to those implants all while being 3000 miles from the comfort of your home? Well? <insert crickets sound effect here> Yeah thought so. ;)

Monday, December 16, 2013

OK so this post won't be about soccer (futbol)...I just liked this graphic so I "borrowed" it. But it is about what I found to be some of the differences between CR & MX dentists. I researched for over 6 months on where to go to get my teeth fixed after realizing I couldn't comfortably afford the procedure that I truly wanted here in the states.

This last summer I went to see a local dentist that specializes in implant supported snap-in dentures (removable). I was very uneducated about all the different types of procedures that are available and their costs. The treatment plan I received was to extract all upper teeth, put in 4 implants which would then support a full upper denture (plastic teeth). Price: over $15K but insurance would have brought my costs down to approximately $13K...maybe $12. I set up my appointments with this doctor, who I liked and trusted and still do, and then went home and started to research. That's what started it right there...the beginning of a journey. I started to learn about teeth made of porcelain & zirconia, mini implants, 1 stage & 2 stage implants, hybrid dentures, all-on-4, 6 & 8 procedures and so on. I just starting spending hours upon hours of soaking in all the info I could find. I realized I wanted a better option than a snap-in/removable denture with plastic teeth. I decided that I wanted something like a fixed porcelain arch consisting of 10 to 12 teeth retained by 6 to 8 two-stage implants. Non-removable and aesthetically superior to the first option I was considering. But then I learned that to get a procedure like that it would be over $40k at least just for the upper. I was bummed but somewhere in my researching I came upon something called "dental tourism".

I first learned of Los Algodones, MX so I poured hours upon hours of research into just that place. Algodones is just across the boarder from Yuma, AZ. It's a small town but has literally hundreds of dentists. I believe it receives more dental tourists than any other place in the world. Many visitors are snowbirds and the care they receive there seems to be pretty good and the prices are about 1/3 of the U.S. prices. I contacted several dentists there and also was able to chat via email with a few past patients to get their review on how everything went for them. I also found some great blogs where people told their story of getting dental work done in Los Algodones ("Wheeling It" blog).

Next I researched other parts of Mexico such as Tijuana, Los Mochis, Cancun, Merida, Guadalajara and others. Talking with a few dentists here and there, some by email and others by phone. I briefly researched India, Hungary and Thailand but the dental prices were not any cheaper than Mexico and of course it costs more to travel to those places so I didn't see the point in going that far. A few of the top places in MX that I was considering was Sunset Dental (Alan is great) & Ocean Dental in Cancun. Yucatan Dental in Merida.

Next was Costa Rica. Actually I was already researching CR a little during my MX research but now I was diving head first into CR and really doing everything I could to just cross it off my list since it was further and a bit more expensive to travel to. I'm in the PNW (Pacific Northwest) and flying to a place such as Cancun is a couple hundred dollars cheaper for me than flying to SJO (San Jose, Costa Rica). Those who live on the east coast or southern states of the U.S. I believe can get to CR cheaper than I can as it's a shorter flight for them. For example from my airport (PDX) it's about 3,300 miles as the crow flies to CR. From a place like Atlanta it's only 1,600 miles. Anyhow as I said I was learning all I could regarding CR dentists. I contacted several and spoke with 3 or 4 or 7 on the phone. The more I learned, and after talking to those dentists, I started to realize that crossing CR off the list just due to slightly higher travel costs was probably NOT a good idea. Some of these doctors impressed me more than any others that I spoke with in any country...U.S. included. Professional, highly experienced and trained, straight forward and honest is what I found in most of the CR dentists. There are a few dentists there that are actually just as expensive as in the U.S. such as the Dr. Gil clinic but most have comparable prices to Mexico. One clinic in San Jose that I learned of has probably the lowest prices and not surprisingly seems to be the most popular among dental tourists in the capital city and it is the International Dental Clinic but many call it the Cavallini Clinic. The senior dentist is Dr. Marco Cavallini although from what I hear his son, Dr. Marco Peralta (still have no idea how the first, middle, last, family name thing works down there), now does most if not all of the major work but not sure how entirely accurate that statement is. From what I hear the downside to this clinic is the waiting time. You can have a 9am appointment but not get in the chair until sometime in the afternoon but once again I must say that I do not know if this is true but rather what I have learned from some that have been there. I know that if getting some great dental work done at the best prices in town meant I had to experience long wait times I'm pretty sure I would be OK with that compromise. Most of the other clinics I researched in San Jose are pretty much within the same price range of each other but about 20% more than the Cavallini clinic but that greatly depends on what procedure one is looking to get. But those other clinics seem to offer a more personalized experience and generally you are not waiting too long if at all past your appointment time. Now obviously I have not been to Costa Rica yet so this information that I have learned is mainly from people who have been there for dental work.

Summary: This is just my opinion and in no way am I trying to belittle or disrespect Mexico dentists but the differences I found between dentists in Costa Rica and Mexico are these....

-dentists in CR, for the most part, seem to have better credentials than many of the ones I researched in MX

-there are some MX clinics that are super modern (I mentioned them earlier) and are up to speed with the latest techniques and equipment but there are so many that still seem to be stuck in the 90's and some even in the 80's or later as far as equipment, technique & sanitary aspects

-when talking on the phone with these dentists I found the ones in CR, for the most part, to be more professional, understanding, patient and respectful.

-MX has an advantage to U.S. citizens and that is you can hop in your car, cross the border and get some good dental care....if you do your research. This of course lessens the expenses and thus your total price for getting dental work done in a border town is going to be less than going to CR even though the actual dental costs are roughly the same...for the most part

-When I was asking a certain MX dentist about warranty/guarantee on their work they said that not many offer this and no one anywhere offers a lifetime guarantee and I found this to be true with the majority of MX dentists. But in CR most do offer some type of warranty on their work. Some offer only a year, some 2 years, another offers 10 years on all work done and even a couple I found offer a lifetime warranty on their work performed. The fact that more CR dentists are willing to back up their work than MX dentists says a lot to me and I think I'll end this long winded post on that.

Saturday, December 14, 2013

My dental trip to Costa Rica is approaching fast. Faster then I had expected. Wrapping up some final details and preparing for this life changing journey. I'm in my 40's and I have no idea what it's like to have a nice straight and white smile. I'm ready. This is big for me.

Monday, December 9, 2013

I don't think you have to be an expert to look at this pano x-ray and see how messed up my chompers are. Look at the #18 tooth which is the molar on the lower far right. See how the bone has receded away from the root? But the teeth that are in the most need of help are the uppers. I will probably be having at least the upper front 8 teeth extracted (#5 thru #12), implants and then new PFM (porcelain fused to metal) teeth or Zirconia teeth or a combination of the two.